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The wrong approach?
Posted: August 17, 2014 | Author: pinkunderbelly | Filed under: breast cancer, Surgery | Tags: breast cancer in young women, cancer of the nipple, CPM, gut instinct, infectious disease, JP drains, micobacterium fortuitum, Paget Disease, post-mastectomy infection, prophylactic mastectomy | 7 Comments
In this article for The New York Times, Peggy Orenstein addresses one of the many tricky topics surrounding breast cancer: to remove or not remove the "unaffected" breast?
It's a tricky topic because the research and prevailing medical consensus are in direct opposition to gut instinct. Research says a bilateral mastectomy in patients with cancer in just one breast has little impact on survivability. Doctors say the odds of surviving low-grade noninvasive breast cancer is the same whether we undergo a lumpectomy or a mastectomy. But our guts often say "lop em both off."
That's what my gut told me to do, even after extensive research and number-crunching. My gut instinct leaped immediately to a slash-and-burn tactic. My darling breast surgeon required me to wait at least 3 days before making my decision on the lumpectomy vs mastectomy debate; I complied but my decision was made in the first 10 minutes of grasping my diagnosis. My gut told me to opt for the bilateral mastectomy.
I suppose this puts me in the category of women opting for a CPM, or contralateral prophylactic mastectomy. The experts whom Orenstein spoke to about the CPM debate refer to the increase in women undergoing CPM as "epidemic" and "alarming" and believe it is driven by women not fully understanding the math. Girls have always been bad at math, right? That's the message I got, growing up in the 1970s in suburban America.
A 2013 study done by Boston's famed Dana-Farber clinic revealed that women younger than 40 with no increased genetic risk who had cancer in one breast believed that "within five years, 10 out of 100 of them would develop it in the other; the actual risk is about 2 to 4 percent."
Upon my diagnosis, I understood the math. It wasn't easy and it was confusing. It took time and effort, but it was not beyond me (having a math guru in the house helped tremendously, but the point still stands). I understood that my chances of successfully removing the cancer in my "affected" breast was the same whether it was done via lumpectomy or mastectomy. I understood that my chances of developing the same cancer in the other breast were slim to none, because, as Orenstein says,"cancer doesn't just leap from breast to breast." I understood that low-grade noninvasive lazy cancers don't typically become deadly; it takes a cancer that metastasizes to do that.
I also understood that a bilateral mastectomy is not an easy surgery. Not by a long shot. As Orenstein so colorfully describes it, "breasts don't just screw off, like jar lids." Undergoing a mastectomy involves not only losing the breast itself but also (typically) the nipple and areola, as well as the lining of the chest muscles. Factor in the JP drains that are snaked into the traumatized chest, just to add insult to injury. I couldn't lift my arms for days after my mastectomy and needed help with the simplest things, such as brushing my teeth and applying chapstick. I needed a new, temporary wardrobe of tops that buttoned or zipped up, because lifting my arms over my head to put on or take off a shirt was a no-go for my battered upper body. I needed help — lots of help — which doesn't jive with my stubborn and independent countenance.
I knew that choosing the harder road of a bilateral mastectomy over the easier, less-invasive lumpectomy did not increase my odds of surviving breast cancer. At least according to the studies. I knew that a mastectomy is much riskier than a lumpectomy. I knew that recovery would be much harder and more time-consuming. Nonetheless, my gut told me to take that more difficult road. My gut was right.
Orenstein spoke to Steven J. Katz, a University of Michigan professor of medicine and health management. He studies medical decision-making, and has found that people tend to react from the gut when confronted with a diagnosis because we are wired to make "fast-flow decisions" that make us want to flee. Understandable to anyone who has been on the other side of the doctor delivering bad news. Upon diagnosis, Orenstein recalls feeling "as if a humongous cockroach had been dropped onto my chest. I could barely contain the urge to bat frantically at my breast screaming, 'Get it off! Get it off!'" Her version involved a giant cockroach; my version involved a scorched earth.
Dr. Katz says that doctors need to understand how our gut reaction affects our post-diagnosis decision. He speaks of "the power of anticipated regret: how people imagine they'd feel if their illness returned and they had not done 'everything' to fight it when they'd had the chance. Patients will go to extremes to restore peace of mind, even undergoing surgery that, paradoxically, won't change the medical basis for their fear."
It is a paradox: our intellectual self versus our gut.
Orenstein points out that "it seems almost primal to offer up a healthy breast to fate, as a symbol of our willingness to give all we have to and for our families. It's hard to imagine, by contrast, that someone with a basal cell carcinoma on one ear would needlessly remove the other one 'just in case' or for the sake of symmetry."
While it may be hard to imagine, there's no way to predict how one will react to a cancer diagnosis. All the studies and statistics are worthless in the face of the worst-possible scenario, which is facing cancer. I was 40 years old, with 2 kids under the age of 10, when I faced that scenario. Of course I thought of them and the possibility of leaving them motherless and rudderless. Having lost my own sweet mama brought that into even clearer focus. Perhaps my decision to undergo a CPM was based more on emotion than on rational thought. No doubt my gut was driving that bus.
But guess what? My gut is a careful and prescient driver. In steering me toward the more-radical surgery option, my gut saved me. Maybe saved my life, but definitely saved me from undergoing a second mastectomy, one that would most definitely not have been of the CPM variety.
My "unaffected" breast had cancer, too. And Paget disease to boot. Nothing had showed up on any of the myriad tests or scans I'd had before my mastectomy. It was the surgical pathology on the "unaffected" breast that finally revealed those cancers. How long would those cancers have grown, unannounced and unaccounted for, had I not followed my instinct and listened to my gut? I don't like to think about that.
I've learned — the hard way, of course — that I'm one of those medical weirdos whose body does not conform to standard protocols. I'm the kook who gets the weird stuff; to wit, Paget disease accounts for a mere 1 to 4 percent all breast cancers, according to the National Cancer Institute. Ditto the post-mastectomy infection I contracted. Who gets a microbacterium fortitum?? So few people that my infectious disease team — yes, I had a team of ID docs — still wonders where the hell that originated.
We medical weirdos don't fit into studies or facts or figures. We are the ones who keep their doctors up at night, scratching their heads and wondering what?? what?? what is going on here?? We are the ones for whom the "if it can go wrong, it will" axiom applies. We are the ones who make other people reassess the shittyness of their situation (you're welcome, by the way).
We are the ones who follow our gut and don't look back. Is that the wrong approach? Not for me.
Fever-free, finally?
Posted: August 31, 2011 | Author: pinkunderbelly | Filed under: breast cancer, cancer fatigue, drugs, infection | Tags: Houston medical center, infectious disease, long-term antibiotics, Maria Pace-Wynters, post-mastectomy infection, psychological effects of breast cancer | 7 Comments
Yesterday was the first day since my surgery–exactly one week ago–that I didn't have a fever for most of the day. I wasn't exactly fever-free, as my temp peaked at bedtime, but that's the best it's been for one very long week, so I'm claiming it. After coming this close to needing IV antibiotics — again — I'm beyond thrilled to have been (mostly) fever-free yesterday. I'm guessing that the docs in my life would laugh a little, shake their heads, and maybe massage their temples a bit at me claiming yesterday as fever-free. I'm guessing my friends in the white coats would consider my being almost fever-free akin to being a little bit pregnant–it's an all-or-nothing condition. That's fine. They can chuckle and shake their heads at me, I'm still claiming it as a victory.
See, fever can indicate infection, and after my surgery last week, the fear of recurrent or new infection abounded. That fear was thick in the OR and it was pervasive in the days after surgery as we waited to see what would happen. It's still lingering, in the back of my mind and on the fringes of my daily activities. I'm not a big fan of that loss of control. We did increase my course of oral antibiotics — both in duration of course and milligrams per dose. The usual suspects in the roster of awful side effects are back, but that tells me the abx are working. If there was a niggling infection trying to re-establish itself, the mounds of abx I've been taking for the last 7 days have contained it. I'm almost afraid to say this out loud, but I think I'm out of the woods.
Can it be? Like the joyous girl in the gorgeous Maria Pace-Wynters art, coincidentally titled "Out of the Woods," I want to smile big and enjoy the view of the woods from the other side. I want to feel the relief that washes over me as I realize that the 6-day fever has broken, the pain & redness & swelling in the original infection site have abated, and I may be able to breathe easily now.
My infection-induced PTSD makes me wonder if I really can believe that the tide is turning, that I may be out of the woods. It's been a long, long haul. A super-long haul. Reflecting back on the havoc that the post-mastectomy infection has wrought makes me very uncomfortable. I'm not yet in that happy place, and the calamity is not far enough in the rear-view mirror yet. Instead of feeling enormous pride, accomplishment, gratitude and general kick-ass-itude that it's over, I'm gun-shy and untrusting.
This time last year, I was fresh out of the hospital, having just served day 27 of intermittent, back & forth hospital stays and at-home IV antibiotics. The last hospital stay to treat the infection was at Methodist in the Med Center, so I'd served time in 3 different hospitals–Memorial Hermann Southwest, Methodist Sugar Land, and Methodist Med Center–which allowed me to sample Houston's best. I recall the direct-admit to the Med Center for the last stay, late on a Sunday night just before school started. Sweet Dr S had handled the details for me so I had a "fast pass" to get admitted quick, which allowed me to circumvent the circus that is a Med Center ER on a weekend night. Dr S and I were texting back & forth during the speedier-yet-still-complicated process so he would know that I was in the room before he had to get up and leave his family to come see me and get all of our ducks in a row.
I remember being furious about having to go back into the hospital. At that point last year, I'd been on antibiotics all summer, oral and IV, in every imaginable combination. Biaxin. Cipro. Minocycline. Zyvox. Vancomycin. Cefapim. Doxcycline. Bactrim.Vancanese. Levaquin. We were on the cusp of finding the magic bullets that would target the slow-growing and slow-to-kill infection (Bactrim & Minocycline), but it would take time to decimate the wily bacteria, so the infection still had the upper hand. As I settled into my room after navigating the maze that is Methodist Med Center, I was completely and utterly pissed at the ugly-ass artwork in my room. The shoddy impressionist landscape was hideous, the colors were barf-inducing, and the mere site of it reminded me that I was once again a prisoner — of my failing body and of yet another hospital. I couldn't avoid that uproariously unpleasing "artwork" because it was in my face and I had nowhere to go to avoid it. That framed print became a symbol, a poster-child if you will, for all that had gone wrong last summer, and I was stuck staring at it. If I hadn't been so ticked and so upset, I would have taken a picture of that "artwork," and one day it will make me laugh instead of making me want to punch someone. But not yet.
Here's what I wrote upon settling into that room; note the frustration surrounding the words that described the room but actually meant a whole lot more:
So I got through the masses in the ER pretty quickly and got into my room and thought, yuck, this place is a dump compared to my lovely one-bedroom suite at Methodist Sugar Land. Call me a snob, but I like those hardwood floors and new, unchipped paint. I don't really need the laminated sign on the wall here reminding me not to leave my dentures on my lunch tray. The view out my dirty window is of a wall, with patient rooms too far away to spy into [one of my pastimes at Methodist Sugar Land]. The chair I'm sitting in to type this is vinyl, and there is a lovely faux-cherry-wood desk with ornate colonial drawer pulls. I could sit there, but the desk chair is super scratched with dingy upholstery on the seat cover. And don't even get me started on the artwork on the wall across from the 20-year-old bed covered in ultra-scratchy sheets. No wonder people get sick in hospitals. It's from the decor as much as the bacteria.
I was one unhappy girl.
I was coming to terms with the fact that the infection superseded the cancer in every way. For a while, that was a good thing — being so focused on the infection kept me from thinking about the fact that I was a 41-year-old mother of 2 young kids battling cancer. The cancer was easy compared to the infection. While a cancer diagnosis is one of the scariest things ever, the treatment for and eradication of that cancer was, for me, much more logical and linear than the infection. The cancer left me flat-chested, but once the tumors were removed and the lymph nodes declared clear, it was done. My game plan was defined: a 5-year course of Tamoxifen for adjuvant therapy along with hormone suppression to snuff the cancer's fuel. The cancer battle was over and the treatment had begun, but the infection war hadn't even revved up yet. Little did I know that more than a year later, I'd still be fighting that war, and that sometimes the infection would gain ground and force me to retreat.
The infection left me with a hole in my newly flat chest — literally. The excised tissue created a wound that measured 5.6 cm long and 3 cm wide. Grab yourself a ruler and feast your eyes on those dimensions. That bad boy took 8 weeks to heal, almost double the healing time required by my bilateral mastectomy. I'd faced my diagnosis, done my research, made the hard decisions, endured the systematic removal of both breasts, and was still standing. The infection, however, was a whole 'nother ball game. There was no logic and nothing was linear — it was a guessing game. Educated guesses by a crack team of infectious disease docs, but a guessing game nonetheless. Will this combo of antibiotics work? How long will I need to stay on them? How will we know if they're working? What are the side-effects of long-term abx therapy? Will I ever get my normal life back? The questions were many, the answers were few. I wrote this after one particularly frustrating day in the infection war:
All this talk you hear about being a pro-active patient, being your own advocate, researching and digging up as much info as you can and thinking for yourself — forget it. Today is one of those days that makes me wish I was a sheep. I just want to follow along and do what I was told. Except I can't. It's not how I'm made. So I continue to ask questions and solicit advice, all the while feeling like I don't have all the puzzle pieces. Sometimes there are a few pieces missing, or you have to wait a while for them to fall into place. You can't force it, although I want to. I am impatient and a forcer. An impatient forcer.
And I'm still waiting for the pieces to fall into place.
Meanwhile, I will feast my eyes on another gorgeous piece from Maria Pace-Wynters's collection. This one is titled "Unseen Beauty," and my eyes are open.
No autographs, please
Posted: July 11, 2011 | Author: pinkunderbelly | Filed under: baseball, breast cancer, infection | Tags: baseball, breast cancer, cancer battle, First Colony Little League, hospital, infection, infectious disease, IV antibiotics, Little League All Stars, mastectomy, post-mastectomy, psychological effects of cancer, recovery, summer camp, Vancomycin | 4 Comments
Today is a very good day, for 3 reasons, maybe more. #1: Macy started two weeks of Fine Arts camp, which she loves (and I'm rather fond of having a few hours to myself while she's off doing fun projects that someone else cleans up, and by "someone else" I mean anyone but me). While she hasn't gotten quite this messy in a while, she's definitely still got it in 'er.
#2: I did push-ups at the gym this morning. It's been a long time since I've been able to do them, and there's a bit of pride on the line since I was working out with my 12-year-old son. I wasn't about to let him see me doing "girlie" push-ups with bent knees, so I tried the real thing, and while it didn't feel great, I did it. Pre-cancer, pre-mastectomy, and pre-infection, I used to be able to do 50 push-ups like it was nothing, and while I'm not there yet, I'm getting closer.
#3: The article for which Payton and I were interviewed was published in our community newspaper. Corey the reporter was nice, and I think he's a good writer. He has covered the district All Star games for all the ages, and he's made the games come alive in his stories. P really enjoyed being interviewed; I like the drama of the article, especially the part in which I'm portrayed as "fighting for my life" (cue the dramatic music here).
It's a good reminder to be careful what you say, too, because I joked with Corey about P having gotten his mad baseball skills from my side of the family. While it's true–my dad's baseball career started with PeeWee ball in 1948 and ended with him playing for the University of Tulsa–I was being smart-aleky, and Corey not only took it seriously but also included that in the article! I certainly don't want to sound like one of "those" baseball moms. I think my kid is a good player who happens to have some natural athletic ability and a body built for taking some hard knocks. However, I'm under no illusion that he's going to play ball for a living when he grows up, and his *$#& most definitely stinks.
While I can take or leave the publicity, reading the latest article did make me realize that a whole lot has changed since this time last year. And most of that change has been good. Really good.
This time last year, Payton's All Star team was preparing for the sectional tournament, which they totally dominated, BTW. But I was fighting another battle against that damned nosocomial infection and was back in the hospital. Again. So after P's team swept the sectional tourney, they were preparing to go to the State Championship in the lovely Tyler, TX. I remember thinking on that Monday, the day I was admitted to the hospital–again–that we'd get the infection under control, pump in some more vancomycin and I'd be on my way to Tyler.
Yes, I was that delusional.
Instead of the scenario playing out the way I'd envisioned, it went something like this: I was admitted on a Monday and didn't get out until Thursday. An area that started as a red, streaky site on the mastectomied right chest wall had to be opened up, drained, excised, and packed with gauze. Repeatedly. The packing part was particularly brutal. See, there was a bunch of fluid inside my chest wall from the infection. Dr S cut a track–sans anesthesia, I recall–to open and elongate the drain hole, to let the fluid out. Once the track was there, though, it had to be packed with gauze to soak up all the nasty fluid. It wasn't a quick process, because the hole and the track were small but had to be completely filled with gauze, for maximum soaking. Thus, a lot of shoving in an already sore, infected, and aggravated area was required. As was a lot of xanax. At one point, after Dr S shoved the gauze into the open wound, my blood pressure was 212/65. That's a little high for me.
I survived 4 days of intense wound-packing and hard-core IV antibiotics. But just barely. I missed the entire State Championship experience, then put my kids on a plane for summer vacation, that I didn't get to attend. I did manage to stay out of the hospital for 2 and a half weeks, but had IV antibiotics at home and a home health care nurse packing that wound. I was hoping to have turned a corner after all that (and more than once wondered what it would take to finally kick that infection) but was back in the hospital again the week before school started.
It was not a good summer, to say the least. This one has been much, much better. While the bar wasn't exactly set very high after last summer, this one is pretty sweet.
A whole new ball game
Posted: June 30, 2011 | Author: pinkunderbelly | Filed under: baseball, breast cancer | Tags: All Stars, baseball, cancer and young kids, cancer battle, First Colony Little League, hospital, infection, infectious disease, Ipad apps, Little League, moms with cancer, post-mastectomy, psychological effects of cancer, recovery, Salisbury Beach, West University Houston | 9 Comments
I'm as nervous as a cat. On a hot tin roof.
Payton's All Star team was one game away from being district champions last night, and they went down in flames. We'd already beaten the West University team but they came back with a vengeance (and their best pitcher). As a seasoned baseball mom who's used to watching a confident & uber-talented team, I can usually get a read on the game and have a sense of how it's going to end. Last night I didn't have my usual "sixth sense" before the game, and even when our boys launched 2 homers in their first at-bat to take a 3-0 lead, I didn't settle in with my usual feel-good feeling about the outcome.
My kid got hit by a pitch during his first at-bat. Not a wimpy pitch, either, but a smokin' fastball. That fastball thumped his thigh, just above the knee, quite audibly. My mama- bear instinct kicked in and I was on my feet, wondering if my boy would crumple in a heap on top of home plate. Then my rational brain kicked in and reminded me that my boy is tough as nails and meaner than a red hog on the field. He takes pain like it's a cool summer breeze, as if it's a "woonty" on the shore of Salisbury Beach. His pain tolerance is incredible, and yes, he gets that from me. He's the ideal football player — a coach's dream — because he'd rather take a beating than admit he's hurt. Most kids take a "test jog" down the right-field line after being hit by a pitch, to make sure they can still run without a hitch in their giddy-up. Not my kid. After being pounded, my kid just casually tossed his bat and trotted to first base. Not a wince or a whimper from him.
Here's the after-effect. I expect it to become much more colorful in the coming days.
Payton's teammate Gus responded to the bean-ball by hitting a homer off the pitcher who pegged my kid. Way to go, Gus!
Sadly, the First Colony bats weren't as hot for the rest of the game, and we came up short. Errors in the field added insult to injury, and the boys in red got a long, stern talking-to from their coaches instead of a celebratory toast at the local pizza joint.
We face West U again tonight, and will likely bring a renewed vigor for victory. It's winner take all tonight, so the stakes are high. Whichever team goes home tonight with a victory moves on to the sectional tournament, with hopes of progressing through that and onto the State Championship. Last year, that team was ours, and we're all hoping for a repeat performance.
No one wants this more than me, since I missed every bit of it last summer. Thanks to a post-mastectomy infection, I was in the hospital instead of in the stands. The team honored me by wearing pink sweatbands throughout the summer, and Payton still wears his. We had to get a new pair, though, because the original pair was filthy. The kind of filth that repeated washings and soakings and pre-treating can't remove. Lots of sweat but no tears last summer.
Apparently I'm a bit nervous , as I was awake at 4:20 a.m. thinking about tonight's game. Someone asked me at the gym the other day if I'm one of "those baseball moms." I wasn't sure what she meant — the kind of baseball mom who attends all the games and cheers for everyone on the team? Or the kind of baseball mom who gripes at the coach and yells at the umpire about being unfair toward her baby? I've seen both kinds. I like to think of myself as the former, but I have been known to yell at an ump a time or two over a particularly egregious call. I am the kind of baseball mom who wears my kid's jersey to the games, proudly displaying #11 on my back just as my kid does. I am the kind of baseball mom who decorates the car windows, as is tradition around here, so that everyone on the road and in the parking lot know that there's an All Star on board.
I am the kind of baseball mom who feels deep pride at my kid being selected for All Stars. 20 players are chosen, then that group is whittled down to 11 or 12 for the traveling team. Lots of players — and lots of moms — would give their eye teeth to be a part of this team. Missing the games and the camaraderie last summer was hard. Really hard. I was able to follow along with the games via an iPad app that allows a user at the game to enter the pitch-by-pitch action so a user on the other end can follow the play-by-play. One of the moms asked me last night if it's more nerve-wracking to follow along or to watch the game live. I said watching live is way more nerve-wracking. Sitting in a hospital bed staring at the iPad screen isn't nearly as complete an experience as being in the stands, in the heat, with the roar of the crowd and the sounds of the game. I do have fond memories, though, of the nurses who were constantly in and out of my room getting involved and asking for updates on the game. And I distinctly remember forgoing pain medicine so I could be lucid enough to follow the game. This summer is a whole new ball game, for me.
Posted: June 22, 2011 | Author: pinkunderbelly | Filed under: breast cancer | Tags: breast cancer, cancer battle, cancer diagnosis, Fuqua School of Business, hospital, Houston, infection, infectious disease, IV antibiotics, MBAs, mycobacterium, older grad students, post-mastectomy, PTSD, recovery, South Padre Island, survivor, top-10 business school | 8 Comments
Once upon a time, in a city far, far from Houston, there was a group of young-ish women. All had relocated from every corner of the country with young kids in tow to help fulfill their husbands' dream of getting an MBA from a top-10 business school. None of the women knew anyone in the new city, and all were a long way from home. For two long years, without paychecks and luxuries like babysitters, the women bonded while the hubs crammed their brains with all things MBA-related. Once the menfolk had diplomas in hand, the group of women dispersed, to new homes in new corners of the country. One night before going separate ways, the women left the hubs and kids at home and went out for a nice dinner. There the plans were laid and a vow was made: let neither distance nor the rigors of child-rearing sever the bond created by hardship and the shared need for breaks from their preschoolers. The solution: come together for an annual girls' trip, to reconnect and recharge.
The first trip was to San Francisco, then Sanibel Island in Florida. Next came Captiva Island, then Scottsdale. Park City was next, followed by Lake Tahoe. Every year was a different locale, but the theme was the same: reconnecting.
The women had gone their separate ways, and a few left the domestic scene to pursue careers in law and medicine. The others continued to toil on the homefront, trading preschool and playdates for elementary school and homework. The kids grew up, and a few new babies joined the fold. One thing remained the same, however: the women's commitment to the annual trip.
Well, not really the end. Just the end of my little story.
It's the eve of the 7th annual Duke girls' trip, and my suitcase is packed. My boarding pass is printed. My Kindle is full of new books to be read uninterrupted by young children. My house is stocked for my peeps to exist in relative ease in my absence. I'm going, I'm really going.
After 7 years, you'd think that preparations for the trip would be somewhat by rote. Decide on the locale, find lodging, book flights, pack a bag, kiss the fam good-bye, and vamoose.
But not for me. See, last year I was ready for Tahoe. That trip was to have taken place 4 weeks post-mastectomy. As I described it this time last year, the trip was "my goal, a partial finish-line, and my sanity-saver since my diagnosis." One of the first things I asked my superstar breast surgeon, Dr Dempsey, upon diagnosis, was if I'd still be able to take my girls' trip. Tahoe with my Duke girls gave me something concrete to work toward in my recovery from surgery, from being diagnosed with cancer at age 40.
Instead of stocking the fridge and packing my bags this time last year, I was in the hospital, sick–really sick–with a nasty infection. I was admitted to the hospital unexpectedly when symptoms of the infection appeared out of nowhere. I literally had seen Dr S the day before the symptoms cropped up; fine one day, sick the next. The day I was hospitalized, I was still clinging to the hope that I'd be in & out of there quickly and still be able to go on my trip. Silly, silly girl. My mind was willing, but my body said "No can do."
After countless IV bags full of different antibiotics, my fever kept spiking and I got worse instead of better. While the scarier bugs like anthrax were quickly ruled out, the specific infection remained elusive. My infectious disease doc told me that the cultures grow at their own pace, and the culturing is done old-school: in a Petrie dish in an incubator in the lab downstairs. I was confined to the hospital bed until the growth was complete, and no one knew when that would occur. The day before the Tahoe trip, I had to concede that I wasn't going to make it. Rotten luck.
While it broke my heart and seriously injured my fighting spirit to tell my Duke girls I wouldn't be joining them, untold hard times followed. Missing the trip was chump changed compared to what was to come. Looking back at my Caring Bridge journal entry for June 10th of last year yielded this:
"I should be on a plane right now, en route to Tahoe, but instead I'm in an ugly gown, sitting on scratchy sheets in an uncomfortable bed (most definitely not a Tempurpedic mattress). Looks like I'll be here a while yet."
I don't recall this part, but it must have happened:
"They moved me across the hall last night to a new room. My new neighbor is an older Asian man who talks louder than anyone I know, and so do all of his relatives. In fact, I just got up my scratchy sheets & walked across the hall in my ugly gown to shut his door. Sheesh. This hospital has an entire floor for Asian patients, which is pretty cool and indicative of this huge city we live in, but I'm wondering why he's not on that floor."
Tonight, on the eve of the 7th annual Duke girls' trip, there are no scratchy sheets and there is no ugly gown. There's a not-so-youngish-anymore woman who's had one helluva year, who's ready to get on that plane and make up for lost time. SPI, here I come. Now that's a happy ending!
At the ballpark, again
Posted: June 22, 2011 | Author: pinkunderbelly | Filed under: baseball, breast cancer | Tags: baseball, breast cancer, cancer battle, cancer diagnosis, family, First Colony All Stars, gratitude after cancer, hospital, infection, infectious disease, life after cancer, Little League, mycobacterium, nosocomial infection, post-mastectomy infection, psychological effects of cancer, survivor, young kids and cancer | 5 Comments
Last summer was pretty bad for me and my family. It started innocently enough, with a bilateral mastectomy at age 40 on May 13th, and while I healed quickly and nicely from that, it all went downhill fast.
Just after my 41st birthday, I got a nasty post-surgery infection. No one saw it coming, and to say it took us all by surprise would be a gross understatement. The odds of contracting a nosocomial infection are not small, but my infection is somewhat rare, quite wily, and super slow to treat. In the scope of inconvenient infections, I won the lottery.
Last night was the first game of the All Star tournament for Payton's team–something I missed entirely last summer. Being present last night to watch my boy do what he does best with his team of like-minded and uber-talented buddies was one of the simplest yet deepest thrills of all time. We take a lot of things for granted in this life of ours, and being able to sit on metal bleachers in the Texas heat in June to watch youth baseball is one of those things. I've sat through thousands of games for my little ball player, and hardly thought twice about it beyond the random, mundane thoughts associated with this endeavor: who are we "versing" (as our catcher, #10 Carl says)? Where is Payton in the line-up? Are we on the shady side of the field? Did I remember my stadium seat? How many times will Macy hit the concession stand? How many pieces of bubble gum does Pay have in his mouth at once?
Those are the thoughts that traverse my brain during a game, along with the usual baseball stuff: What's the run rule in this tournament?; How did we fare against this team last time we met? If the ball hits the bat then hits the batter, he's out, right? Rules and regulations course through my head as I follow the many games my boy has played.
Last night was different, though. As I was ready to walk out the door, our bestie Ed reminded me that I've come a long way since this time last year. Several of the parents on our team remarked at the park that it's nice to have me there this year. A couple of the coaches said something about having missed me and my big mouth last summer; once a cheerleader, always a cheerleader.
I have come a long way since last summer, and watching my kid play ball is something to be savored, something to most definitely not take for granted. The metal bleachers, the roar of the crowd, the (gross) smell of hot dogs, the infield dirt blowing in my eyes…every bit of it is special to me on a whole 'nother level.
Last night also marked the first time a newspaper reporter has covered the game, and seeing my boy's name in print in association with his rock-star team's blowout and his personal success is something I'll be savoring for a while. Before cancer came into my life, I would have enjoyed reading the article, and likely would have forwarded it to our nearest & dearest, but this time, I'm carrying the feeling of that article along with me, inside my heart, in that little space where the gratitude lies.
I was flipping through my old Caring Bridge blog, and happened upon this entry, which seems even more prescient a year later. I wrote this on the morning of my mastectomy, before leaving for the hospital. No doubt I was antsy, preoccupied, and ready to get the show on the road that morning. It seems appropriate to reprint it today, in light of the theme of today's blog.
I realize that when cancer comes into one's life it disrupts everything and changes "the normal" forever. Dr Dempsey, my superstar breast surgeon, told me you no longer schedule cancer around your life, you schedule your life around your cancer. Life takes a backseat to war.
With cancer, I join a club that I never signed up for and for which I never wanted to become a member.
No matter, I now have a new normal. The new normal is all about taking care of what's most important. We hear this all the time, but when you really put it into play in your own life, you know exactly what it means. For me, it means facing this beast head on and telling the bastard repeatedly that it doesn't stand a chance. It means never once, not even once, considering that this cancer will win. It's not even in the game.
It also means all the pithy stuff you hear about, like savor every day, make the most our of whatever you've got. That's also true. For me it means truly embracing and enjoying my kids and my family, and letting my friends into my life — warts & all — on a whole new level. Y'all may well see my house a mess, which doesn't happen much. You may see me in a grumpy mood (ok, you've seen that, esp on the tennis court!). You may see me just a teensy bit vulnerable, but only for a short time so don't expect a repeat performance. No matter what, there is a new normal, and I'm all over it.
As if the tornado wasn't bad enough…
Posted: June 14, 2011 | Author: pinkunderbelly | Filed under: breast cancer, infection | Tags: AL East, Alex Rogriguez, Antibiotics, Dustin Pedroia, Freeman Hospital, fungus, hurricane categories, infection, infectious disease, Jacoby Ellsbury, Joplin tornado, mucormycosis, mycobacterium, psychological effects of cancer, PTSD, recovery, Red Sox Nation, survivor, tornado EF-5 | 1 Comment
I feel a weird dichotomy of emotion when a friend hears about a rare and hard-to-treat infection and thinks of me. On one hand, it's nice that my friends are the sort of people who know what's going on in my life (I guess being a blabbermouth and having a blog help). On the other hand, it's a weird feeling to be the one associated with the rare and hard-to-treat infection.
No matter, the horse is out of the barn, and the fact of the matter is that I did indeed have a rare and hard-to-treat infection, I am a blabbermouth, I do have a blog, and my friends rock.
So when the news broke that several people in the wake of last month's giant killer tornado in Joplin, Missouri, have contracted a rare and hard-to-treat infection, my name came to mind. Perhaps this provides a bit of perspective for me. On many levels. It reminds me that while I've been through a lot, I also have a lot for which to be grateful. Namely things like this: #1, I wasn't involved in the devastation of that giant killer tornado. #2, my rare infection was hard to diagnose but not especially hard to treat; just a giant pain in the ass. #3, my rare infection wasn't deadly, as the one in Joplin is. #4, my rare infection is gone, baby gone. And, because I like odd numbers in lists, #5, I'm done with the 267-day course of oral antibiotics needed to treat my rare, pain-in-the-ass infection. Oh, if only I got paid extra for using hyphens in my modifiers.
The giant tornado last month in Joplin stirred up a lot of soil in its destructive path, and it uncovered mucormycosis, a deadly fungus among us. Like most bacteria and fungus, mucormycosis is all around us but only affects people who are already limping along with weakened immunity. The proverbial kicking a man who's already down. It seems to prey upon people with diabetes, leukemia, lymphoma, and AIDS as well as those who have had an organ transplant and those who engage in chronic steroid use (Alex Rodriguez, you better be careful).
I must digress here for a moment about the mighty A-Rod. We don't like him much in our house (understatement of the year, right there). Not just because we are die-hard, hard-core Red Sox fans and he's on that other AL East team. You know, the one that wears those gawd-awful pinstripes. Ick. Well, A-Rod, in our opinion, typifies everything that's wrong with pro sports: the drugs, the attitude, the disdain for the very fans who provide him job security. Imagine our surprise and delight when we found this yesterday:
An A-Rod baseball card, chewed to bits by our little dog Pedey. I love it! It's even funnier because that little dog is named for Payton's favorite Red Sox player, Dustin Pedroia. The idea of Pedey going after A-Rod fills my heart with pride. I've said before that Pedey is not much like his namesake: he's lazy and clumsy with a ball, but in this case, Pedroia would be proud of this little dog for pouncing on A-Rod and tearing him to bits!
As long as we're digressing for baseball-related ramblings, I might as well post a pic of my boy-crush, Jacoby Ellsbury. It's been a while, and I know my loyal readers have missed him. Here ya go.
Ok, back to the Joplin tornado and its unwelcome sidekick. The tornado was a big one. An EF-5 to be precise. The EF scale refers to the Enhanced Fujita scale, which was developed at the Wind Science and Engineering Research Center at Texas Tech University. Yay Red Raiders. I don't know much about the tornado scale, being a bit more familiar in this neck of the woods with the Saffir-Simpson Hurricane scale, but a quick peek on Wikipedia tells me that an EF-5 tornado means the storm has winds in excess of 200 mph. A bad-ass, scary storm, to be precise.
The May 22nd tornado cut the city of Joplin roughly in half with an estimated 7-mile-long by 1-mile-wide swath. It moved slowly and stayed on the ground rather than touching down and moving back up. All of these factors combined equal untold destruction, a death toll of 151 people, and the unleashing of a nasty fungus.
Eight tornado victims have contracted the mucormycosis, although public health officials won't make an official link between the fungus and the tornado. Four of the people who tested positive for mucormycosis have died. It's a nasty bug that spreads fast and can invade the blood supply of its victims, who typically have injuries and secondary wound infections. Sound familiar? Ugh. The rush of feelings and memories this topic evokes roars in my head much like a tornado. I think my PTSD is showing.
The mycormycosis fungus is usually found in soil and wood and enters the body either through a puncture wound or when a person breathes in mold spores. The dirt or vegetation becomes embedded under the skin, and mold is actually found in the wounds of people who have this bug. In some cases, wounds that had been stitched up after the tornado had to be reopened to clean out the contamination. Again, sound familiar? The incubation period is a little shorter on the fungus compared to the mycobacterium, and hopefully the fungus presents itself faster than the myco; both times I've been tested for that damn myco it took 6 weeks to present itself.
People with weakened immune systems who come into contact with this fungus have a mortality rate as high as 90 percent. Yes, you read that right: 90 percent.
wikipedia.com
It's strange how the spores of this fungus look almost artistic under the microscope, yet can wreak unimaginable havoc on the human body. Compare that to my bacteria's photo and you can see how vastly different these bugs appear under the microscope and why I have enormous respect for my sweet infectious disease doc. You rock, Dr Grimes!
Because the mucormycosis fungus is so rare, medical research is limited, and treatment is simple but fraught with complications. Treating it sounds eerily familiar to me: confirm the bug, excise the affected tissue via surgery, and administer long-term and powerful antibiotics. Same plan I followed for the mycobacterium.
The Centers for Disease Control and Prevention said Friday that it is conducting tests to help investigate the infections, which are so uncommon that even the nation's largest hospitals might see only one or two cases a year. In fact, Dr Ewe Schmidt, infectious disease specialist at Joplin's Freeman Hospital, said that in 30 years of practice, he's seen 2 cases of mucormycosis, both of which occurred in patients who had untreated diabetes.
"To my knowledge, a cluster like this [several cases of the fungus] has not been reported before," said Dr. Benjamin Park, head of the CDC team that investigates fungal diseases. "This is a very rare fungus. And for people who do get the disease, it can be extremely severe."
I'm so glad my rare infection wasn't this deadly fungus. I'm even more glad that my rare infection is gone. And I'm so glad this guy and his dog survived the storm and the deadly fungus.
The SCAR Project
Posted: May 19, 2011 | Author: pinkunderbelly | Filed under: breast cancer, cancer fatigue, infection, Surgery | Tags: "just write", Barbara Delinsky, breast cancer, cancer battle, cancer diagnosis, David Jay photographer, infectious disease, Nancy K Brinker, new boobs, pink ribbons, plastic surgery, post-mastectomy, Promise Me book, Race for the Cure, reconstruction, recovery, survivor, Susan G Komen, The SCAR Project, Uplift, Wordpress, young cancer patients | 20 Comments
duggal.com
Listen up, people: this is really important.
If you're not familiar with The SCAR Project, I am happy to introduce you. I'll be honest: there are some photos that may disturb you, because the photos show "large-scale portraits of young breast cancer survivors," and present a "raw, unflinching face of early onset breast cancer while paying tribute to the courage and spirit of so many brave young women," according to the project's website. While the photos are indeed raw and unflinching themselves, I challenge you to man up and look at them anyway. They're very tastefully done, no train-wreck gore or gratuitously scary stuff. Get past the cover model who is visibly pregnant and sporting a single-mastectomy scar on her chest. Her belly is beautiful, as it contains a newly forming life, and her scar is a badge of honor.
The project's acronym stands for "Surviving Cancer. Absolute Reality."
I like that little double entendre. Well, let's be honest: I like most double entendres, but this one in particular speaks to me. As does the project's media slogan: "Breast Cancer Is Not a Pink Ribbon."
And how.
one of the many "pink ribbon" cards I've received
I'm all for the pink-it-up attitude that the Susan G Komen for the Cure and other organizations espouse. While I think it's a little weird to see the pink ribbon and "awareness campaign" on products ranging from golf balls to toilet paper and all parts in between, and while I question how much all this awareness really does to actually fight the dreaded disease, I am grateful that Suzy Goodman Komen was the kind of woman who wanted to make a difference, even though she would not be a survivor. Because of her and her family, most notably her sister Nancy G. Brinker, breast cancer went from a shameful secret shrouded in secrecy to the glamour disease du jour.
I'm not interested in getting into the debate in the BC community over how much good the Komen organization has actually done. I completely understand the frustration felt by women with Stage IV BC over the lack of research done on their end of this vicious disease. According to Brinker's book, Promise Me, the Komen organization has contributed some $1.5 billion to research and community programs, but it seems that precious little reaches the metastatic BC demographic. I understand, and I struggle to see the connection between awareness and finding a cure. Regardless of funds and allocation, however, I'm grateful that in the 25+ years that Komen has been around, the global breast cancer movement has worked to eradicate the shame that used to accompany a BC diagnosis. The SCAR Project is following suit.
As I've mentioned before, Bestselling author Barbara Delinsky also lost a loved one to BC. Delinsky was 8 years old when her mom died from BC, yet according to her book Uplift, she was in her teens before she learned that her mom had breast cancer, and it was years before her dad could say cancer, and even longer before he could say breast.
One of the women featured in Uplift, Elinor Farber, lost her mom to BC, too, and said when her mom was diagnosed 45 years ago, there were no mammograms, and mastectomies were just short of a butchering. Farber reports that her mom lived more than 30 years after her surgery, but never once spoke of her condition. "Mom endured everything without the support of friends and neighbors, who were not told. My sister and I were both told of my mom's condition in hushed tones, and we were sworn to secrecy."
We've come a long way.
But not until The SCAR Project have people been forced to see–I mean really see–the impact of breast cancer.
The project focuses on women aged 18 to 35, a demographic in the breast cancer community that is not well represented. Although it's estimated that more than 100,00 women younger than 40 will be diagnosed with BC this year, and although BC is the #1 cause of death of women aged 18 to 40, the younger members of the pink ribbon club don't get a lot of press.
When I was diagnosed last April at the tender young age of 40, I quickly learned just how little press we young-uns get. All of the literature I received from my darling breast surgeon featured grey-haired grannies. Not a single image in any literature showed anyone within 20 years of my age. My darling breast surgeon, who is younger than me, agreed that the lit needs a major overhaul, and she teased me about being the one to get the ball rolling. Sure thing. Now that I'm finally off the antibiotics and over the post-mastectomy infection, I'm on it.
Sadly, I'm too old for The SCAR Project; otherwise, I would sign up right this second to be a SCAR model. Well, not right this second but after living in the gym for several months and eating nothing but salad. No dressing. Kidding. After countless doctor visits and multiple hospital stays, I've long shed any modesty about disrobing, and I've been known to show my scars in all their glory to anyone who asks. The nurses in my various doctors' offices don't even offer me the paper gown anymore, because they know I won't use it. Save a tree, people; I'm over it. In fact, I may contact photographer David Jay and tell him I'm overage but have an abundance of scars. Way more than the women on the SCAR website. No that it's a contest or anything.
dailymaverick,.com
Like Komen, the initial goal of The SCAR Project was to raise awareness and money. But it became so much more. Jay explains that he was not prepared for something so beautiful:
"For these young women, having their portrait taken seems to represent their personal victory over this terrifying disease. It helps them reclaim their sexuality, identity, and power after having been robbed of such an important part of it. Through these simple pictures, they seem to gain some acceptance of what has happened to them, and the strength to move forward with pride."
Yeah! Go girls! This model from The SCAR Project looks like the epitome of a fierce survivor. While no doubt she's battle-weary and has seen things and faced trials she never thought possible, the mere fact that she participated in The SCAR Project tells me that she is indeed moving forward with pride.
lipmag.com
I'm not quite there yet, personally, with reclaiming all that has been lost to my cancer, but after seeing the women in The SCAR Project, I'm a whole lot closer.
Posted: May 13, 2011 | Author: pinkunderbelly | Filed under: breast cancer, drugs, food, infection, kids, pets, Surgery, tennis | Tags: Bactrim, blog, breast cancer, cancer battle, cancer diagnosis, champagne, coconut cream pie, DIEP, dogs, family, hospital, Houston, infection, infectious disease, IV antibiotics, kids, kids dealing with mom's cancer, lymphedema, mastectomy, Methodist Hospital, microsurgery, minocycline, Moet, mycobacterium, nausea, new boobs, plastic surgeon, plastic surgery, post-mastectomy, reconstruction, recovery, stress, surgery, survivor, tennis | 12 Comments
Y'all know I'm a milestone-observing kind of girl. I've written about my cancer-versary, about a revelation, about week-old recollections after The Big Dig, aka my reconstruction, and returning to the tennis court after a long absence full of longing.
I've written about the anniversary of my sweet mama leaving this earth. That was early on in my blogging, and I hadn't mastered the art of inserting photos. The photos of her are woefully displayed, and in my free time (!) I need to go back and fix them. She deserves better.
I've also observed the end of the worst year of my life. "Don't let the door hit ya" was my message to 2010 as it went out like a lion. A mean, underfed, on-the-hunt-for-victims lion. Almost halfway through 2011 and I'm happy to say it's turning out to be a much better year. Course, we didn't have far to go to make it better than its predecessor.
Back to the current milestone. One year ago today, I said bye-bye to my breasts and was the lucky recipient of a flat–but cancer-free–chest. This was me, this time last year. On this very day (although it wasn't a Friday, it was May 13th. Having a bilateral mastectomy on Friday the 13th would be cruel).
Trevor snapped this photo of me waiting for my surgery, in the holding pen before moving to a pre-op room. My brain was swirling with lots of thoughts, too many thoughts, and I was likely firing off a quick email to our BFF Ed with some last-minute kid-wrangling instructions. Notice the pink notebook in my bag: my cancer book, full of pathology reports, doctors' notes, research, and bills. Bills, bills, and more bills. I think the current estimate of the cost of my last year medically is in the range of $260,000. And we're not done spending yet.
One year ago today, I wish we'd thought to take a close-up shot of my chest instead of the deep wrinkle snaking across my forehead. My chest would never be the same, and would become a major battleground–and that was after the mastectomy. If I'd seen that pic before going under, I would have asked Dr Dempsey, breast surgeon extraordinnaire, to give me some Botox while she was in there. Yikes.
I didn't know what to expect from the surgery, other than the basics. With subsequent surgeries, I've learned that actual procedures are available for viewing on youtube and I've watched a few. Gross. But amazing.
All I knew, really, was that I had breast cancer and I wanted it gone. I could have had a lumpectomy, but chose the slash-and-burn option instead. I'm not a half-measure kind of girl, and the idea of just taking a part of the infected breast instead of the whole thing wasn't anything I ever seriously entertained. Slash-and-burn meant taking both breasts, even though the cancer was only detected in the right one. Only. Ha! Good thing I lost the pair, because the post-mastectomy pathology showed the left one had some problems, too. If you can call an area 5 cm in diameter full of cancerous junk a problem. I can, and I did. Little did I know then, one year ago today, that pretty much anything that could go wrong with my post-surgery self would go wrong. As my nurse practitioner friend Laura says, "Your case certainly has not been textbook." Truer words were never spoken, but we didn't know that one year ago today.
Because there were only 3 weeks between my diagnosis and the mastectomy, and because most of that time was consumed with tests, tests, and more tests, there wasn't a lot of time for freaking out or being scared or crying about my fate. Not that I would have done any of those things anyway. There was a problem, and we were going to fix it. 'Nuff said. I had a great team–breast surgeon, plastic surgeon, and oncologist– and was in a nationally ranked and highly acclaimed hospital. Course, I'd end up adding a kick-ass infectious disease team, home-health care nurse, a beloved lymphedema specialist, and wound specialists to my team before it was all said & done.
Dr Grimes, my hero
Tammy Sweed, I adore you!
The week before surgery, Payton turned 11
and Macy & I pampered ourselves with a Chinese foot massage.
I squeezed in as much time as I could with my girls
I didn't know it would be a while before I did anything like this with my favorite girl.
Going into surgery one year ago today, I had no idea that I'd end up spending nearly a month more in the hospital and undergo 3 more surgeries; minor surgeries compared with the mastectomy, and of course reconstruction was way off in the distance, with even more days in the hospital. I had no idea how much I'd miss my kids while hospitalized
and my dogs (and their friends).
I had no idea how many times I'd need the special parking place.
I had no idea how much infinite kindness my friends would bestow upon me. We were on the receiving end of many, many meals delivered to our house, a kindness for which I'm so grateful. The rides to & from my kids' activities helped more than I could ever guess. The sleepovers and outings that my mommy friends provided kept my kids' life normal when everything else around them was off-the-charts abnormal.
My cousin Teri's hubby Tom made me more than one coconut cream pie. I ate a lot of this
but not nearly enough of this
Keith's crab towers were chock-full of healing properties.
As was this:
Yes, lots of champagne eased the way from being an average, suburban at-home mom to becoming a statistic. From regular woman to cancer vixen. From got-it-together overachiever to at the beast's mercy. And my bubbly companion continues to ease the way, from cancer victim to cancer survivor. Cheers to that.
A week after surgery, I began to feel a bit more human and was blown away by my little girl wearing a pink ribbon on her shirt–all her idea, BTW–to school every day.
I was not enjoying the amount of time spent doing this:
although Pedey enjoyed every lazy minute of my recouperating.
Seeing me in jammies all the time gave Macy an idea: she could raid my jammie drawer and wear them herself.
I'm not sure I ever got that pair back from her.
I certainly have learned a lot over the last year. Things I never knew I would have to learn, like the difference between invasive ductal carcinoma and in situ carcinomas. Like how a tumor is graded to determine the stage of the cancer. Like cure rate statistics and recurrence stats. Like how fine a line there is between the science of medicine and the art of medicine. Like how fighting a wily infection could be even worse than fighting cancer.
The crash course in all things infection-related was a big education. A very big, most unwanted education. My biggest lesson in this arena is how many unknowns exist. I wanted to know when, where, how, and why I got this infection. No one knows for sure. I wanted to know why it took so long to diagnose it, and why so many drugs have to be involved. I learned that my oncologist could have me all my drugs delivered to my doorstep via UPS. I learned to love vanocmycin and to depend on probiotics. I learned to eat breakfast as soon as I got up, hungry or not, because I needed to time the antibiotics right so they hit an empty stomach. I learned that morning sickness-style nausea doesn't go away as the morning changes to afternoon and then to evening. I learned that there was nothing, not one single thing, I could put in my stomach to ease that awful nausea. I learned that washing those drugs down with alcohol doesn't make me feel worse; that in fact it made me feel a whole lot better. I learned to develop a schedule and a rhythm to taking my antibiotics every 12 hours for 267 days.
I learned that "We're discontinuing the antibiotics" are the sweetest words I've heard in a long time. I've learned about the complete and utter relief of dumping my remaining oral abx out, because I don't need them anymore.
That's the tip of the iceburg, or what my friend Michele would call "a booger's worth" of the practical things I've learned. The topical aspects of changing one's status from normal person to cancer patient. Then there's the other side of it.
There's the stuff I've learned in the last year about the unquantifiable side of a serious illness. The depth of inner strength required to get through something like this. The well of emotion that accompanies the clinical stuff. The patience and fortitude I didn't know I had (although I'm still working on the patience part). The measure of gratitude toward the people who've helped along the way. The unbridled joy of making new friends in the midst of a shitty situation. The passion for writing, long dormant in the day-to-day of child-rearing, and the love of blogging. The understanding that my doctors are just regular people under those scrubs & white coats, and while they're full of knowledge, there's a whole 'nother side of unknown things for which they make an educated guess and hope for the best. And, I have to admit, how much fun I've had getting to know these people in the white coats.
While being diagnosed with breast cancer at age 40 certainly does suck, I'm lucky that I made the decision one year ago to not let that diagnosis define me or impede me living my life. There certainly were times in which I was miserable from surgery and infection, and down in the dumps about my limited capabilities during recovery. There were also times over the last year in which I thought for a second I can't take any more–not one drop more of bad luck, rotten news, and beastly complications. But those times didn't last long and they did not prevail. Cancer did not prevail. Not over me. No way. Nuh uh. That's perhaps the most important thing I learned over the last year.
The best news in a long time
Posted: May 6, 2011 | Author: pinkunderbelly | Filed under: breast cancer, drugs, infection, tennis | Tags: Antibiotics, infectious disease, mycobacterium, nosocomial infection, Pommery, post-mastectomy infection, Seinfeld, tennis, witch is dead, Wizard of Oz | 16 Comments
After 267 days, I finally heard the words I've been dreaming about: "We are discontinuing the antibiotics."
Cue the hallelujah chorus.
I saw Dr Samo instead of Dr Grimes today, and he delivered the most-excellent news. He is my new best friend. All of the cultures run during The Big Dig came back negative, which means we can safely assume the post-mastectomy infection is gone. Yes, at long last, the mycobacterium has been vanquished.
Let me say that again: the infection is gone. I'm cured.
No more twice-daily dose of minocycline and bactrim. No more nausea. No more planning my consumption of food & drink around my doses. No more remembering to take my drugs. No more antibiotics.
Oh, happy day!
I'm still in a mild state of shock, or maybe just slightly buzzed. Could be the celebratory champagne straight away after returning from the medical center (duh), and the margarita at my tennis team's end-of-season lunch.
We broke out the good stuff and gathered our close circle of friends who would never say "it's too early" and question the wisdom of popping a cork at 11 a.m. To Amy, my chief medical correspondent and chauffeur to & from appointments: thank you. For everything. To Jill & Keith: thank you for rushing right over, then leaving as soon as the bubbly was gone. But for planning to come back with dinner.
My tennis team's luncheon was already planned, but how fun to celebrate my big news with some of my favorite girls? And how cool that they gave me a huge, signed tennis ball? Thanks, girls!
The infection is gone. Ding dong, the witch is dead.
sodahead.com
I half expected the citizens of Munchkin Land to come out and dance their little legs off and sing in their froggy voices to celebrate.
bufordbetty.com
I admit, I've been wondering all week if my visit to the infectious disease doc today would result in the end of the abx. I was trying to not get my hopes up, and while I knew not to expect it, I would have been disappointed if they'd said keep on swallowing those pills. No matter. It's all good now.
I will also admit that when the nurse was taking my BP and temp and asking me the reason for my visit, I felt funny saying "yes" to her question of "are you here to see if it's time to get off of the antibiotics?" It was almost too much to hope for. Almost.
Then when Dr Samo uttered those glorious words of "We are discontinuing the antibiotics," I was stunned. It was a bit surreal. Once I grasped what he'd said, my first thought was that "discontinuing" meant taking a break, not stopping them altogether.
It was almost too much to take in.
As my best buddy Ed said, "I feel I should shove you and yell 'Get Out!' like Elaine on Seinfeld.
googleimages.com
"Get Out!" indeed.
The end of the antibiotics is like an end of an era. My life has revolved around them for so long now–one week shy of a year, in which I've been on some form of abx, whether oral or IV. Nearly a year on some pretty powerful drugs, and none of them the fun kind. Nope, these are the ones that tear up your stomach and make your insides cry like a baby.
But no more.
Big sigh.
The fat lady can sign her heart out right now.


text:
Romance Books for Teenagers
4.12 (106,271 ratings by Goodreads)
By (author) Adam Silvera
Adam Silvera reminds us that there's no life without death and no love without loss in this devastating yet uplifting story about two people whose lives change over the course of one unforgettable day.
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In the tradition of Before I Fall and If I Stay, They Both Die at the End is a tour de force from acclaimed author Adam Silvera, whose debut, More Happy Than Not, the New York Times called "profound."
Publisher Quill Tree Books
Bestsellers rank 1,258
We here at Last Friend Inc. are collectively sorry for this loss of you. Our deepest sympathies extend to those who love you and those who will never meet you. We hope you find a new friend of value to spend your final hours with today.
On September 5, a little after midnight, Death-Cast calls Mateo Torrez and Rufus Emeterio to give them some bad news: They're going to die today. Mateo and Rufus are total strangers, but, for different reasons, they're both looking to make a new friend on their End Day. The good news: There's an app for that. It's called Last Friend, and through it, Rufus and Mateo are about to meet up for one last great adventure--to live a lifetime in a single day.
Uplifting and devastating, charming and haunting, They Both Die at the End is a tour de force from acclaimed author Adam Silvera, whose debut novel the New York Times called "profound." It's a story that reminds us there's no life without death, no love without loss--and that it's possible to change your whole world in a day.
"Silvera not only poignantly captures the raw emotion of facing your own morality, but creates such relatable and authentic characters you want to follow on their journey. His gorgeous writing and wonderful storytelling will wreck you in the very best possible way."--Buzzfeed
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redpajama_set_name: RedPajamaCommonCrawl


If you have not paid your traffic fines, your UAE residence visa will not be renewed. This is the effect of a new visa rule which however was created before some months. But it was now officially declared by the Ministry of Interior on Monday.
Brigadier General Dr Rashid Sultan Al Kidhr - Deputy Director-General for the Legal Council at the Ministry of Interior for Immigration, Residency and Ports Affairs, said in a message that those individuals who may have not paid their traffic violation fines will not be able to renew their residence visa. "Clear your traffic fines first and then come for the renewal of residence permit," Dr Al Kidhr said.
Residents say that the rule, even though officially announced only on Monday, has been around place for several months.
Dr Al Kidhr said that the traffic violation payment is currently linked with the immigration department at the federal government level: "If you have traffic violation fines, you will not be able to renew your UAE visa or benefit from any other immigration-related transactions," he described.
He further declared that all the concerned departments have been informed about the new rules and asked to upgrade their data system.
An official at the ministry stated that the laws and regulations may added to include bank defaulters, specifically credit card holders who actually have never settled their debts.
Dr Al Kidhr said the ministry was looking at expanding the recovery of fines to all types of immigration and other government transactions. "Recovery of fines will be included to every government departments. The traffic rule violation fine recovery is the just beginning. No one will be spared," he described.


text:
Ceylinco General Insurance records Rs.18bn premium income in 2017
20 February 2018 12:00 am - 0 - {{hitsCtrl.values.hits}}
Ceylinco General Insurance Ltd., announced results for the financial year ended 31st December 2017 recently.
Ajith Gunawardena, Chief Executive Officer of Ceylinco General Insurance, announcing the results said: "During 2017, the company recorded a premium income of Rs. 18 billion (Rs. 17,977 million), with an impressive growth of 11.5 percent, which signifies an increase of Rs. 1.9 billion over the previous year.
When considering the stiff competition that exists in the market, last year's performance was outstanding. Despite the price undercutting practiced by some players, customers have understood the value of Ceylinco VIP On The Spot.
"We believe in providing a superior service to our customers and our differentiation is not on price but on our exemplary claim settlement and the value we add to our products and services. We have worked hard together and surpassed expectations and our own benchmarks.
"We remain committed in exercising disciplined control and maintaining far-sighted leadership. As always, this performance is entirely due to the firm belief the Sri Lankan public has placed in us, and the efforts of each and every member of the Ceylinco General Insurance family. Our humble thanks and heartfelt gratitude are extended to all those who made such a feat possible."
Elaborating further on the remarkable figures, Patrick Alwis, Managing Director of Ceylinco General Insurance Ltd, said: "Ceylinco General Insurance paid claims amounting to Rs. 9 billion (Rs. 8,967 million) during 2017, settling all genuine claims within 24 hours. This includes the large number of flood and cyclone claims that were paid within a period of 14 days, enabling customers to return to normalcy in the fastest possible time. We are the only company to do so."
Alwis further said, "I pay a special tribute to the staff of Ceylinco General Insurance who acted promptly to pay compensation to all of its policy holders with flood and cyclone cover who were affected by the floods and the inclement weather that created havoc in 2017. We assure the insuring public of our continued efforts to bring better and faster solutions to benefit them even further."
In a landmark move, in August 2017, Ceylinco General Insurance announced yet another innovation in Motor Insurance - a Rs. 1 million cover that reimburses medical costs incurred in the treatment of heart disease, cancer, kidney failure, stroke and several other serious illnesses including heart attack and open heart surgery, major organ transplants, chronic lung and liver diseases, deafness, blindness, multiple sclerosis, paralysis etc. Introduced as an exclusive benefit for Ceylinco VIP On The Spot policy holders, this benefit will undoubtedly ease the financial burden to a great extent in the event of an illness


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Choose a Outdoor DIVAS coupon you would like to use from Promocode.club. Press use Outdoor DIVAS code box, which is located just below. Now your web browser should copy the All 0 Outdoor DIVAS code for you, although it is best to make sure and copy it manually. The http://www.outdoordivas.com web page will open in a new window for you. Go to their Outdoor DIVAS checkout section and find the Promotional Keycode box. Paste your Outdoor DIVAS coupon code there and click apply.


The Bears on Wednesday signed free-agent running back Shaun Draughn to a one-year contract, the team said.
He joins Michael Ford as the only tailbacks on the roster behind Pro Bowler Matt Forte.
Draughn has averaged 3.7 yards on 63 carries in 20 career games, 17 of which were with the Kansas City Chiefs. He has two career touchdowns.
The Chiefs signed Draughn to their practice squad in 2011, when Bears general manager Phil Emery was their director of college scouting.
Coach Marc Trestman has said his main requirement for Forte's backup is an ability to pass block.


The Shockwatch Clips are impact sensors designed for mounting directly onto the product itself. They allow you to monitor your product through every phase of its manufacturing cycle; from assembly line to shipping to the final customer. The Shockwatch Clips can be customized to fit your specifications, providing damage reduction whenever and wherever your products are handled.
These highly precise sensors are affected only by the specific impacts for which they were designed. The Shockwatch Clips are small and economical enough to justify adoption in a variety of manufacturing, testing, and field monitoring applications.
Use the Shockwatch Clip to provide the ability to conduct incoming and outgoing quality assurance inspections to produce zero defect shipping. Used as an education tool, you can control assembly and distribution personnel, thereby improving handling during the manufacturing process. The Shockwatch Clip can also be used to aid in assuring product integrity.
By monitoring your products in the hands of the end user, the Clip can be used to prevent warranty abuse, resulting in reduced services calls. Used countless times in the evaluation of packaging, each Shockwatch Clip has been precisely tested to work under many different handling conditions. The Clip can be an invaluable tool in comparing foams and external packaging in comparison to elaborate and costly laboratory procedures. In effect, the Shockwatch Clip can actually reduce packaging costs.


text:
Remember Henry Harris
Subscribe to receive occasional articles, updates, event dates, and book news.
Henry Harris
Alabama Public Radio Commentary
Alabama Public Radio aired a poignant commentary today on the life and sacrifice of Henry Harris — and how he has been forgotten in his home state of Alabama. Written by program director Brittany Young and with audio by Dr. Robin Boylorn, the commentary concludes that...
Henry Harris: Captain America
In the foreboding dark days when the Nazis were rolling through Europe and the Japanese were building ships of war and slaughtering neighbors, a hero arose from the thin pages of an American comic book. He came to slay evil, to vanquish villains. It was 1941, and he...
It's Now The 'Perry Wallace Way'
Vanderbilt and the city of Nashville have renamed a seven-block section of 25th Avenue South "Perry Wallace Way" in honor of the first black basketball player in the SEC. Ironically, but appropriately, Wallace wore number 25 at Vanderbilt, which retired his number in...
Harris's Farewell Earns an Ovation
Here are excerpts from Chapter 27 of Remember Henry Harris, describing Harris's final home game at Auburn on February 26, 1972. Pages 197-200 With 1:18 left to play, Harris fouled out with ten points, three rebounds, and four assists. Unselfish to the end, he had...
Occasional news, events, and book news.
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I had called S & S Heating & AC when my mother's air conditioner was making a horrible noise back in August. It was evening when I contacted them so it was after hours and when most companies would immediately categorize the call as emergency hours. What was impressive is that the owner, Adam, was immediately concerned about the well being of my mother first, once it was known that she was a retiree. He wanted to make sure she was comfortable and if she needed immediate help. Once she described the noise she was hearing and the temperature in the house (luckily this was during some of the cooler days in August) they determined she would be okay through the night and he promised to come out first thing the next morning. He arrived when he said he would, assessed the problem and offered solutions that worked. Adam advised my mother that the motor on the unit should have been under warranty and the repair covered. The original company that installed the AC unit never informed her of this. The honesty, the quality of service and the care that Adam and S&S Heating & AC showed were greatly appreciated and we will continue to use their service.
We have been customers of S&S Heating and Cooling for a long time now, so when our air conditioner finally bit the dust after 25+ years, we naturally gave them a call. Keith, one of the managers there, came out and gave a solid estimate, and we accepted his bid. He said he could have installers out within the next few days, because this happened around the Fourth of July week.
His installers showed up July 5th, and took a little more than half a day to do a total teardown and install. The installer was a guy named James, who was conscientious, hard working, and detailed. His manager, Brian, came out to help with the installation a little later, and he, too, was all of the above adjectives. A couple of friendlier service people you will not meet.
After the installation, they tested the system, and they found that they had the wrong sized filter for the air handler. I said that as long as they got me one within the week, that would be fine, but they brought the right sized filter to us the very same day. I would flat out use these guys if I run into HVAC problems. They've always taken care of us!
Friendly, efficient personnel and professional explanation of all procedures performed.
Friendly, professional dood service in a timely fashion 5 stars!
Sam did a great job! He arrived when he said he would, which was critical for us in a no heat situation. Thank you!!
Always willing to come out in emergencies, respectful and really nice to boot!
These are hard working and honest people at S & S Heating. They come as fast as anyone, maybe faster, in an emergency and their rates are fair and competitive, lower than the larger companies that service the area. They are neat and clean while performing their service. They never have to come back and finish a job as it is finished when they leave. I purchased a new furnace from S & S two years ago. Their costs were lower than all the quotes I got from a lot of people too. I would recommend S & S highly. They get five stars from me.
Keith is fantastic…honest, knowledgeable and efficient; I could not ask for better. Cindy, in the office, is great, too, as she offers excellent customer service which, sadly, is becoming a thing of the past.
They always take such good care of us @ signofthetymessalon. we appreciate them very much!!
Fast friendly service! Very reliable!
ac stopped working on a 90+ degree day. I'm sure S&S was very busy that day. they still made it out that evening. had us fixed in a matter of 30 minutes or so. Minimal cost and we were able to sleep in a comfortable room that same night. Thanks S&S. I was blown away.


These hummus stuffed pretzel bites use Sabra pizza hummus for a fun football (or anytime!) snack. A salty soft pretzel bite gives way to hummus filled center!
The first time I made pretzels was one of the most satisfying culinary feats of my life. That sounds ridiculous, they're pretzels not foie gras but seriously, I was like giddy with excitement. I get that way with pretty much anything that involves a successful use of yeast but the two step, boil and bake thing pretzels got going on makes it that much better.
My thoughts on pretzels are pretty simple: life's too short to waste any time eating hard pretzels when soft pretzels exist. The end.
I don't think I've ever been tempted by the bowl of hard pretzels at a party. I mean for real, the communion wafer at church tastes better than those things. Half the time they're stale and the other half they're still meh.
Chips win hands down at the "throw it in a bowl and mindlessly eat at a party" food, not pretzels.
Soft pretzels, now that's a completely different story.
How can one pass up a soft salted doughy pretzel from the guy on the street corner in NYC to the Auntie Anne's in the mall with that intoxicating cinnamon pretzel smell wafting around? If you can, I deem you not human.
So with my beloved soft pretzels in mind, these pizza hummus stuffed pretzel bites came to be.
I hear it's football season now (you all know how I feel about this ridiculous sport. If not, see this edamame dip post) and the only thing that means to me is TAILGATING FOOD, pretty much the only good thing to come of this pig skin throwing, man tackling spectacle that takes over all televisions (except mine) every Sunday.
Since pizza is pretty much a staple football food, I figured why not use Sabra's pizza hummus to stuff inside a pretzel bite?
It's like a two for one of tailgating goodness. A salty browned outside opens up to a pizza hummus stuffed doughy inside only made better by a nice big dunk in some more hummus before eating.
Never thought I'd say this, but heck yeah, football!
Combine the warm water and yeast in a small bowl and let sit for about 5 minutes until the yeast blooms.
Add the flour, salt and yeast mixture to the bowl of a stand mixer fitted with a dough hook.
Mix on medium speed for about 3-5 minutes until the dough comes together in a ball around the hook. If needed, add a tablespoon or two of water to get the dough to come together more easily.
Coat the bottom and sides of a medium bowl with the olive oil.
Turn the dough out and form into a ball, place in the greased bowl, cover with a towel and set aside in a warm place to rise for 1-2 hours until about doubled in size.
Once risen, punch the dough down and roll out into a square. Cut into 16 pieces about 2x2 inches each.
Place a teaspoon or so of hummus in the middle of each square. Do not overfill, this will make things messy when trying to pinch closed later.
Brush the beaten egg around the edges of each piece then fold the sides together and pinch closed with your fingers and set aside. Repeat with remaining squares.
Once boiling, add the baking soda slowly.
Drop the pretzel bites into the boiling water 3-4 at a time for about 1-2 minutes each. Remove with a strainer and place on a parchment lined baking sheet. Repeat with remaining pretzel bites.
Brush pretzel bites with remaining egg. Sprinkle with coarse sea salt and bake for about 15 minutes until golden brown.
Remove from oven and serve warm with additional hummus for dipping.
These pretzels really would make such a great party snack!
I have always had an obsession with soft pretzels! This recipe is not only genius but they look amazing! Im sure hummus and soft pretzels together are heaven!
I am with you sister, bring on the soft pretzels, all day long! Love the little surprise in the middle. Such a smart recipe!
This is the perfect tailgate food! I have yet to try that pizza hummus but it's calling my name, and so are these pretzel bites! Awesome recipe!
Pizza, hummus, pretzel…you combined all my favorite foods into tasty little bites. I *LOVE* this!!
This is brilliant! I will definitely be making these for my guys soon!
I hate hard pretzels, they've always seemed like such a sub-par snack to me. But these, man I could make a meal out of these!
Words can't describe how much I love these pretzels.
I have a serious weakness for soft pretzels. Although I do like hard ones too, soft ones are on a totally different plain of existence.


text:
Home › About Antarctica › Antarctic Arts Fellowship › Alumni › 1990-1999 › Coral Tulloch 98-99
Coral Tulloch 1998-99
Author Coral Tulloch
Coral Tulloch visited Antarctica during the 1998/99 summer season. During the trip Coral communicated with school children in Hobart through an online voyage diary and answered questions by email.
On her return, Coral created activity sheets for children with the aim of passing on both her fascination with Antarctica and her passion for preserving its unique qualities. These can be found on our educational resources page.
As the result of her trip, Coral researched, wrote and illustrated a new non-fiction work, Antarctica: Heart of the World, for ABC Books, which won the prestigious Wilderness Society's Environment Award for Children's Literature in 2004. It was published in the United States in March 2006 and was named one of the best books of the year by Science Books and Films US in February 2007.
Coral spent the early part of August 2004 as writer/artist in residence at the Fremantle Children's Literature Centre in Western Australia. Here, an exhibition showcasing the educational material and artwork created as a result of her 1998/99 Fellowship was on display for the 2004 school year.
Coral has also participated on several occasions in the AAD's educational program during the Hobart Midwinter Festival.
Coral has also written a book about Macquarie Island, together with fellow Antarctic Arts Fellow Alison Lester. In 2012, the book was awarded the prestigious Eve Pownall Award for Information Books, by the Children's Book Council of Australia. The book has also won the Wilderness Society's Environment Award for Children's Literature, and the Whitely certificate of commendation in the children's book category from the Royal Zoological Society of New South Wales.
Antarctic Impression
"I have been so privileged to have been a part of the Antarctic Arts Fellowship. From the time I applied for a voyage south with the Australian Antarctic Division, I have been given extraordinary encouragement and support from all the Antarctic family I've been so fortunate to have met. I can think of no greater creative freedom for any artist than what is offered to applicants of this program. Often working in isolation within our particular fields, a voyage south dictates collaboration to achieve its goals. You become a part of the history of an expedition, where a strong bond is created between all who are a part.
"For me, a voyage south was a rite of passage. To enter through the icy fringes of the southern ocean and on to the continent, I found that my perceptions, my ways of describing the life around me were dramatically altered. The enormous power and importance of the continent is humbling and I felt extraordinary peace. My trip south has influenced the last five years of my work and I am unashamedly obsessed by Antarctica. My current projects are a fiction, games and a series of lithographic works based on the continent."
People in Antarctica
Sounds & images
Australia in Antarctica
Antarctic Arts Fellowship
How & when to apply
Sally Robinson 91-92
Charles Page 1993-94
Caroline Durre 94-95
Meredith Hooper 94-95
Denis Crawford 95-96
Janet Boschen 97-98
Andrew Darby 97-98
Felicity Jenkins 97-98
Coral Tulloch 98-99
Grant Dixon 98-99
David Neilson 90-91
Alumni by category
This page was last updated on 21 December 2012.


text:
Ace Hardware announces closing of Prince George facility
By Roger Bell, Editor
PRINCE GEORGE – A national hardware company has announced plans to close its facility in Prince George as it prepares to open a large distribution center in Pennsylvania.
A news release from the company announced that Ace Hardware Corporation, the world's largest retailer-owned hardware cooperative, will be "restructuring" its East Coast retail support by opening a Retail Support Center in Fredericksburg, Pa. This opening is expected by the first quarter of 2018.
The new facility is expected to be a 1.1 million-square-foot site which will serve Ace Hardware facilities throughout Pennsylvania, New Jersey, New York, Virginia and Washington, D.C.
"Following a rigorous analysis of the company's distribution network, including its wholesale division, the company has decided to consolidate its distribution efforts to ultimately strengthen the overall retail support network," the release stated. "As a result, Ace Hardware will close its Retail Support Center in Prince George, Va., a small crossdock in the Baltimore area, and the Emery-Waterhouse operations in Portland, Maine and Piston, Pa."
"Ace Hardware intends to grow even more aggressively over the next several years. As a result, we are augmenting our distribution capabilities to be faster, nimbler and stronger than ever before," said Lori Bossmann, Executive Vice President, Supply Chain, Inventory Replenishment and Retail Support, Ace Hardware Corporation. "We are grateful for the service our team members at these facilities have provided to Ace Hardware and Emery-Waterhouse, and we will work with compassion to ensure a smooth transition during this period of change," Bossmann said.
The release goes on to say the changes to the network will take place in phases over 24 months, with the "valued team members located at the affected facilities, many of whom are tenured," provided a range of "transition services." Relocation options will also be provided to "qualified" team members, according to the release.
Ace Hardware is more than 90 years old, with over 5,000 locally-owned and operated hardware stores located around the world.
The company headquarters is located in Oak Brook, Illinois.
← Virginia representatives split votes as House narrowly passes Obamacare replacement
Prince George EMS considers partnership with new Tri-City Emergency Center →


text:
Q: Treating the contents of a TeX-style group ({\blah ...}) as macro arguments I am trying to make adjustments to a large document that uses TeX-style macros, like this:
{\defun SomeFunctionName arg1 arg2}

The \defun macro is defined as \newcommand{\defun}{\tt}.
Can I adjust this definition to retrieve the SomeFunctionName arg1 arg2 part as an argument, to allow for a more complex definition? Fox example, if defun was a proper LaTeX macro, I could put a box around the text, or put something before and after, etc.
Minimal example:
\documentclass{article}
\newcommand{\defun}{\tt}

\begin{document}
\section{\defun SomeFunctionName arg1 arg2}
Call {\defun SomeFunctionName} to foo the bar.
\end{document}

How could I (for example) add some text before and after every invocation of defun? What is the general approach to handle the contents of {\defun ...} as an argument, short of editing all occurences?
To clarify: this is a large, two decades old document. I didn't write it.

A: You can do it with \aftergroup:
\documentclass{article}

\protected\def\defun{\aftergroup\newdefun\aftergroup{}}
\newcommand\newdefun[1]{\fbox{#1}}

\begin{document}

\tableofcontents

\section{Here {\defun SomeFunctionName arg1 arg2}}
Call {\defun SomeFunctionName} to foo the bar.

\end{document}

The same limitation as David Carlisle's answer holds: calls of \defun that don't appear inside a pair of braces will break. In the case of
\section{\defun Whatever}

the error will be when processing \tableofcontents. But \section{{\defun Whatever}} will behave well.

A:
\documentclass{article}

\protected\def\defun{\expandafter\zdefun\expandafter{\iffalse}\fi}

\def\zdefun#1{A \fbox{#1} B\egroup}

\begin{document}
\section{\defun SomeFunctionName arg1 arg2}
Call {\defun SomeFunctionName} to foo the bar.
\end{document}

Here
\iffalse}\fi

expands to nothing so
\expandafter{\iffalse}\fi

expands to a single unmatched { but is a matching {} so can be included in a definition.
So given
 {\defun SomeFunctionName}

The { starts a group and
\defun SomeFunctionName}

expands in one step to
\expandafter\zdefun\expandafter{\iffalse}\fi SomeFunctionName}

and in the next step to
\zdefun{SomeFunctionName}

\zdefun has a normal #1 argument which is delimited by the { we just inserted and  the } that was originally in the file. (Note this } was originally a group close delimiter, it is now used as an argument delimiter so doesn't close a group.)
So this expands in one step to
A \fbox{SomeFunctionName} B\egroup

and the
A \fbox{SomeFunctionName} B

gets typeset, and finally the
\egroup

closes the group started by the { in the original file.

A: My preferred approach would be: use the find-and-replace function of your editor of choice and replace {\defun with \textdefun{.
EDIT: As @Clément points out, this does not work in cases like \section{\defun abc def}. I am afraid those cases would elude even a more sophisticated regexp-based approach, because one would have to add an additional closing brace.

redpajama_set_name: RedPajamaStackExchange


I'm back from BlogHer and I have to say that it was a wonderful event. I was able to meet a number of food bloggers, as well as a few people who were interested in getting started with food blogging. It is fascinating to hear people talk about why they blog and why they love it, and I'm glad that I was able to be a part of it this year.
The first day, we listened to some more technical talks about things like building traffic and photo blogging. I was inspired to try making a video or two, so if things work out, I might put up a short cooking clip on here sometime in the future. The second day, we all talked about the content of our blogs, why we blog and where our blogs are taking us. For me, one of the best things about blogging is being part of a community of wonderful people (commenters included!) and I was lucky enough to meet with a number of them on day two of the conference. Among the bloggers that I met were, Shuna from Eggbeater (who had some great t-shirts for sale), Pim from Chez Pim, Erin from Erin's Kitchen, Fatemeh of Gastronomie, Meg Hourihan of Megnut and Cheryl of Cupcake Bakeshop.
Saving the best for last, I also spent a lot of time with Elise from Simply Recipes and Kalyn of Kalyn's Kitchen. I can't say enough good things about the two of them, as they are wonderful women. The three of us, along with our conference friends Teri and Allison, all went out to dinner on Saturday night - taking a break from the rather appalling conference food - to an amazing Japanese restaurant in San Jose's Japan Town. We all kept on taking so long, that the restaurant workers were halfway through their meal at the end of the night before we noticed, offered our thanks, and left!
Overall, it was a great experience. I heard, while I was there, that the next BlogHer will be next summer in Chicago. I highly recommend that you come and join us, if you can make it, regardless of whether you are a blogger or simply enjoy reading blogs. We're keeping our fingers crossed for a whole food panel, which would make the conference even better.
Take a look at Elise's post to see some pictures of all your favorite food bloggers, or look at the whole Flickr group from the conference to take a peek at some of the speakers and other activities. Kalyn has a list of all the food bloggers who were able to meet up with us on Saturday, too.


text:
How to find and listen to Internet radio stations using the Windows Media Player 11 software?
Finding and listening to Internet radio stations using the Windows Media Player 11 software.
Information regarding how to listen to Internet radio using the Windows Media Player 11 software can be found on the Microsoft Web site at http://www.microsoft.com/windows/windowsmedia/knowledgecenter/howto/mp11/radio.aspx.
Why is the connection of Windows® Media Player 7 to the Internet not recognized?
Why does an error message appear when accessing the radio function with Windows Media Player 8 and Media using Internet Explorer 6.0?
How to extract audio files from an audio CD using the Windows Media player 8 software?
How to playback a DVD movie full screen using the Windows Media Player v7.x software?
How to delete a song, album, video or other media from the Windows Media Player 9 software?


The outlook for Milltown in the week ahead shows the average daytime maximum temperature will be around 16°C, with a high for the week of 21°C expected on the afternoon of Saturday 20th. The average minimum temperature will be 7°C, dipping to its lowest on the morning of Friday 26th at 3°C. Expect the coming week to have mostly dry days although Wednesday 24th and Thursday 25th are likely to see a little rain. It looks like Thursday 26th will have the most precipitation with an accumulation of around 6.0mm. On the whole winds are likely to be moderate.


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text:
Pacey Williams
Want to know more about Pacey Williams? Get his official bio, social pages and articles on iHeartRadio!Full Bio
A Puppy That Can't Walk & Pigeon That Can't Fly Are Best Friends At Shelter
My heart can't even take it!! This is so adorable!! Meet Herman and Lundy.
Herman is a pigeon who suffered neurological damage and can't fly. Lundy, a newborn chihuahua puppy can't use his back legs.
The two met at Mia Foundation, a rescue organization in Rochester, New York, that rehabilitates animals with birth defects and physical deformities. This is amazing work they do. Some of their animals go to foster and some are kept for school programs about bullying.
The adorable friendship between Herman and Lundy has inspired so many people from all over to donate to the foundation. People from all over the world are now also wanting to adopt Lundy. So far the foundation raised $6000.
Click Hereto Donate